Strategies for Improved Shock Wave Lithotripsy

改进冲击波碎石术的策略

• 批准号: 7695082
• 负责人: ANDREW P EVAN
• 金额: $ 171.26万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-05-10 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7695082
• 关键词: Strategies; Improved; Shock; Wave; Lithotripsy

DESCRIPTION, OVERALL (provided by applicant): We propose a coordinated, highly interactive multidisciplinary collaboration between four Projects and two Cores with the main goal of making shock wave lithotripsy (SWL) safe and effective for all patients. In this work we will: Determine the chronic effects of SWL on the kidney-the long-term effects on renal structure and function that follow induction of acute damage during a treatment session Determine if lithotripsy induces new-onset diabetes Develop treatment protocols that protect patients from SWL adverse effects Determine the properties of SWs at their site of action in the kidney and proximal ureter Increase the efficiency of SWL by improving the acoustic coupling between the lithotripter and the patient Devise treatment protocols that improve SWL outcomes for obese patients Determine the treatment threshold for SWL injury and develop a method to monitor onset of conditions that are damaging to the kidney Evaluate the efficacy and safety of a new trend-low-pressure wide-focal-zone-in clinical lithotripter technology Develop acoustic monitoring and feedback techniques to improve the targeting and firing of lithotripters to eliminate the delivery of SWs that miss the stone, and to determine when the stone has broken to completion and the session can be ended Determine the mechanism by which cavitation within a vessel causes hemorrhage Develop numerical models to understand the role of cavitation and non-cavitational mechanisms in causing tissue damage PUBLIC HEALTH RELEVANCE: Shock wave lithotripsy (SWL) is the most common treatment used to remove renal stones. However, SWL has been found to cause acute trauma to the kidney and surrounding organs that is linked to potentially very serious chronic adverse effects. The proposed research will find ways to make SWL safer and more effective.

总体描述（由申请人提供）：我们提出了四个项目和两个核心之间的协调、高度互动的多学科合作，主要目标是使冲击波碎石术（SWL）对所有患者安全有效。在这项工作中，我们将： 确定SWL对肾脏的慢性影响-对肾脏结构的长期影响， 在治疗期间诱发急性损伤后功能 确定碎石术是否会诱发新发糖尿病 制定保护患者免受SWL不良影响的治疗方案 确定SW在肾脏和近端输尿管中作用部位的特性 通过改善碎石机和碎石机之间的声耦合来提高SWL的效率。 患者 设计改善肥胖患者SWL结局的治疗方案 确定SWL损伤的治疗阈值，并开发一种方法来监测SWL损伤的发生。 损害肾脏的疾病 低压宽聚焦区碎石机临床应用的有效性和安全性评价 技术 发展声学监测和反馈技术，以改进目标瞄准和射击 碎石机，以消除错过结石的SW输送，并确定结石何时 中断完成，会话可以结束 确定血管内空化导致出血的机制 开发数值模型，以了解空化和非空化机制在 导致组织损伤 公共卫生相关性：冲击波碎石术（SWL）是最常见的用于去除肾结石的治疗方法。然而，已发现SWL对肾脏和周围器官造成急性创伤，这与潜在的非常严重的慢性不良反应有关。拟议的研究将找到使SWL更安全，更有效的方法。